<!DOCTYPE html>
<html xmlns:th="http://www.thymeleaf.org">
<meta charset="utf-8">
<head th:include="include :: header"></head>
<body class="gray-bg">
<div class="wrapper wrapper-content ">
    <div class="row">
        <div class="col-sm-12">
            <div class="ibox float-e-margins">
                <div class="ibox-content">
                    <form class="form-horizontal m-t" id="signupForm">

                        <div class="form-group">
                            <label class="col-sm-3 control-label">
                                经销商名称：
                                <span style="color: #e7262a">*</span>
                            </label>
                            <div class="col-sm-8">
                                <input id="agentName" name="agentName" class="form-control" type="text" required
                                       placeholder="经销商名称（必填）">
                            </div>
                        </div>

                        <div class="form-group">
                            <label class="col-sm-3 control-label">
                                联系人:
                                <span style="color: #e7262a">*</span>
                            </label>
                            <div class="col-sm-8">
                                <input id="linkman" name="linkman" class="form-control" type="text" required
                                       placeholder="联系人（必填）">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">
                                电话：
                                <span style="color: #e7262a">*</span>
                            </label>
                            <div class="col-sm-8">
                                <input id="tel" name="tel" class="form-control" type="text" required
                                       placeholder="电话（必填）">
                            </div>
                        </div>

                        <div class="form-group">
                            <label class="col-sm-3 control-label">
                                城市区域：
                                <span style="color: #e7262a">*</span>
                            </label>
                            <div id="target" class="col-sm-8"><!-- container -->
                                <select name="province"></select><!-- 省 -->
                                <select name="city"></select><!-- 市 -->
                                <select name="area"></select><!-- 区 -->
                            </div>
                        </div>

                        <div class="form-group">
                            <label class="col-sm-3 control-label">
                                收货地址：
                                <span style="color: #e7262a">*</span>
                            </label>
                            <div class="col-sm-8">
                                <input id="address" name="address" class="form-control" type="text" required
                                       placeholder="公司地址（必填）">
                            </div>
                        </div>

                        <div class="form-group">
                            <div class="col-sm-8 col-sm-offset-3">
                                <button type="submit" class="btn btn-primary">提交</button>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
<div th:include="include::footer"></div>
<script type="text/javascript" th:src="@{/js/appjs/agent/add.js}" src="/static/js/appjs/agent/add.js">
</script>
<script type="text/javascript" th:inline="javascript">
    $('#target').distpicker();
</script>
</body>
</html>
